The venous side of the systemic vascular circulation returns the left ventricular cardiac output in a converging fashion to the superior and inferior vena cava and hence to the right atrium. Oxygenated blood is returned to the left atrium. The volumes of these 2 systems are in balance in a ...

In cardiac arrest, the ventricular fibrillation (VF) waveform, particularly amplitude spectral area (AMSA) and slope, predicts the return of spontaneous circulation (ROSC), but it is unknown whether the predictive utility differs in an acute myocardial infarction (MI), prior MI, or normal myocardium and if the waveform can distinguish the underlying ...

Acute elevation of circulating lipids, such as the postprandial state, contributes to increased cardiovascular risk. However, the effect of acutely elevated triglycerides on arterial and left ventricular function is not completely understood. We aimed to assess whether an acute increase in triglycerides affects ventricular-vascular interaction. Fifteen healthy men (aged 49±8yrs) ...

Radiofrequency catheter ablation is now the first line treatment for atrioventricular nodal reentrant tachycardia. The success rate is high with a low incidence of complications. However, a possible proarrhythmic effect of radiofrequency energy has been rarely reported and no study has demonstrated a direct correlation between the anatomic site of ...

The healing process is a key determinant for postinfarction left ventricular (LV) remodeling and the development of heart failure, which could be influenced by mechanical (pressure and/or volume) load. So far, limited information exists regarding an indepth characterization of the postinfarct healing process in the mechanically unloaded state. In the ...

Measurements of cardiac troponin (cTn) and natriuretic peptides can predict outcomes after cardiac surgery and may thus assist in decision making about diagnostic and therapeutic steps in this setting. Not every cardiac surgical procedure is associated with the same degree of cTn or natriuretic peptide elevation; the factors known to ...

Ablation Without Fluoroscopy in Pregnancy. Background: Management of symptomatic atrial arrhythmia in pregnancy remains a challenge. In this case report, a pregnant woman with incessant tachycardia underwent successful left atrial ablation. The entire procedure was performed without fluoroscopy. Methods and Results: A 20-year-old woman, 27 weeks pregnant, was admitted with ...

Mitral regurgitation is the most prevalent heart valve disorder in the United States. Individuals with mitral regurgitation may be asymptomatic or may present with dyspnea, orthopnea, fatigue, and/or heart rhythm disturbances. Long-standing mitral regurgitation causes chronic left ventricular volume overload, which leads to left ventricular dilation and contractile dysfunction. Without ...

BACKGROUND: Remote ischaemic pre-conditioning and cardiac ischaemic post-conditioning provide myocardial protection in cardiac surgery. However, these two endogenous strategies have not been directly compared in a clinical setting. The purpose of this study was to compare the efficacy of remote ischaemic pre-conditioning and post-conditioning in providing myocardial protection to children ...

The southeastern region of the United States is known as the "stroke belt" because of excess stroke mortality in this region compared to the rest of the country. However, whether a similar geographic variation in heart failure mortality exists is unknown. Using the Center for Disease Control and Prevention Wide-ranging ...

Herein we investigated a new strategy for the modulation of cardiac macrophages to a reparative state, at a predetermined time after myocardial infarction (MI), in aim to promote resolution of inflammation and elicit infarct repair. The strategy employed intravenous injections of phosphatidylserine (PS)-presenting liposomes, mimicking the anti-inflammatory effects of apoptotic ...

Coronary heart disease (CHD)- and stroke-related mortality rates have been greater in the Southern states than in the rest of the United States. Although a sustained decrease in mortality from CHD and stroke has occurred in the United States during the past 3 decades, it is not known whether a ...

Ischemic postconditioning (IPOC) could be ineffective or even detrimental if the index ischemic duration is either too short or too long. The present study is to demonstrate that oxygen supply and metabolism defines a salvageable ischemic time window of IPOC in mice. C57BL/6 mice underwent coronary artery occlusion followed by ...

Kounis syndrome, also named as "allergic angina syndrome," is a diagnosis in which exposure to an allergen causes mostly coronary spasm and rarely plaque rupture, resulting in ischemic myocardial events. Myocardial bridging is defined as an intramural segment of a coronary artery and its systolic compression by overlying fibers. Myocardial ...

Ablation for atrial fibrillation has become a widely accepted and practiced treatment for this arrhythmia. However, the technique for ablation has evolved over time, particularly for the two distinct groups of paroxysmal and persistent atrial fibrillation. This review outlines the optimal techniques for ablation of these different subgroups of atrial ...

Atrial fibrillation is increasingly prevalent among older adults and is a major contributor to morbidity in this population due to associated strokes, heart failure, and quality of life impairment. Catheter ablation for atrial fibrillation is demonstrated to be superior to antiarrhythmic therapy for the control of symptomatic and medically refractory ...

The formation of atrial-esophageal fistula after catheter ablation for atrial fibrillation is a rare but devastating complication with high mortality. Prevention is of utmost importance. We review the usefulness of currently available preventive measures. Recent studies using endoscopy after atrial fibrillation ablation show the development of esophageal ulcerations in 14-17% ...

Advanced age and female sex are associated with increased myocardial stiffness, even in the absence of cardiovascular disease. Left ventricular (LV) hypertrophy and left atrial (LA) enlargement are typical findings in patients with LV diastolic dysfunction (DD). Because DD has been described in asymptomatic subjects, its clinical impact remains controversial. ...

Left ventricular assist devices (LVADs) offer effective therapy for severe heart failure (HF) as bridge to transplantation or destination therapy. Rarely, the sustained unloading provided by the LVAD has led to cardiac reverse remodelling and recovery, permitting explantation of the device. We describe the clinical course of a patient with ...

Cor triatriatum is a rare congenital cardiac malformation and it usually refers to the left atrium. We report an unusual case of cor triatriatum in a 33 - year old woman presented with congestive heart failure caused by left ventricular systolic dysfunction.

Ultra High-Density Multipolar Mapping With Double Ventricular Access. Analogous to the use of circular loop catheters to guide ablation around the pulmonary veins, it may be advantageous to use a multipolar catheter in the ventricle for rapid mapping and to guide ablation. We describe a technique using double access into ...

Three-dimensional reconstruction of the human heart was performed to define the structure of the intramyocardial microvasculature. A total of 200 consecutive serial sections of 6 μm each were prepared from the left ventricular tissue of an autopsied human heart with normal coronary arteries. The corresponding arteriole, venule and all capillaries ...

We previously reported that the myocardial energetic state, as defined by the ratio of phosphocreatine to ATP (PCr/ATP), was preserved at baseline (BL) in a swine model of chronic myocardial ischemia with mild reduction of myocardial blood flow (MBF) 10 wk after the placement of an external constrictor on the ...

We report the case of a patient with paroxysmal atrial fibrillation in whom 2 previous cavotricuspid isthmus (CTI) ablations were performed for recurrent type I counterclockwise atrial flutter. One year after the last CTI ablation, the patient underwent pulmonary vein isolation for AF and reassessment of conduction block in the ...

Deep cerebral venous thrombosis is an uncommon event. It usually involves the halami and adjacent areas on both sides. Unilateral thalamic infarction is extremely rare subsequent to deep cerebral venous thrombosis. Imaging findings of a female in the postpartum period with unilateral thalamic infarction and basal ganglia edema are presented.

Aims Catheter manipulation during ablation procedures can produce injury and tamponade. We evaluated the mechanical forces required to perforate a porcine heart with an ablation catheter. Methods and results A 7 Fr, 3.5 mm irrigated radiofrequency (RF) ablation catheter with a force sensor (FS) within its tip was used to ...

Background: Cryoablation for arrhythmia substrates in pediatrics has been available since 2003. The purpose of this study was to evaluate the current approach of pediatric electrophysiologists to the use of cryoablation in the current era. Methods: We sent an Internet link to an online survey to all members of the ...

This report describes the incidental finding of complete left atrial standstill during successful ablation of a right-sided atrial tachycardia in a patient with severe dilated cardiomyopathy and a history of extensive catheter ablation within the left atrium.

We describe two cases of no reflow phenomenon in the setting of primary PCI for ST elevation myocardial infarction successfully managed with intracoronary vasodilator therapy via a Clearway™ balloon catheter, where vasodilator therapy via the guiding catheter had been ineffective. Traditionally, if not given via the guiding catheter, vasodilators have ...

Radiofrequency ablation of atrial flutter is a commonly performed procedure. Ablation success depends upon complete transmural atrial tissue injury to achieve bidirectional cavotricuspid isthmus (CTI) block. Transmural ablation increases risk of injury to the adjacent right coronary artery (RCA). Distance between the RCA and the endocardium within the CTI area ...

With the number of complex catheter ablation procedures increasing, procedure-related acute cardiac tamponade is encountered more frequently in the cardiac catheterization laboratory. Survival depends on prompt recognition and rescue pericardiocentesis. The aim of this report was to validate fluoroscopic heart silhouette characteristics associated with cardiac tamponade as a diagnostic method, ...

A case of idiopathic premature ventricular contractions successfully ablated from the epicardial right ventricular outflow tract (RVOT) via the subxiphoid pericardial approach was described. The sites with earliest endocardial and epicardial ventricular activation were located adjacent to each other in the RVOT and at both sites, double potentials were recorded. ...

Aims Electrical storm (ES) adversely affects prognosis of patients and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES. Methods and results Fifty consecutive patients ...

Coronary sinus thrombosis is an extremely rare clinical syndrome with a high fatality rate. It is associated with procedures in the right heart, including insertion of pacemaker wires, Swan-Ganz catheters, and central venous lines. Recognition is often late, and treatment options are not well characterized. We present a case of ...

We describe a case of atypical atrial flutter presenting 1 year after radiofrequency ablation for atrial fibrillation (AF). Electrophysiologic study showed a reentry circuit involving the inferolateral aspect of the mitral annulus and the coronary sinus (CS); however, a mitral isthmus line did not terminate the arrhythmia. Participation of the ...

To determine the safety and efficacy of a standardized approach to the use of an endovascular coronary sinus (CS) catheter during minimally invasive cardiac surgery. Case series. University hospital. Patients undergoing mitral and/or tricuspid valve surgery using a minimally invasive cardiac surgery approach. An endovascular CS catheter was placed to ...

Frequent monomorphic ventricular premature beats (VPBs) may lead to left ventricular dysfunction. We describe two patients with frequent monomorphic VPBs and dilated cardiomyopathy in whom left ventricular function normalised after elimination of the VPBs by radiofrequency catheter ablation. The recent literature on this topic is summarised and potential candidates for ...

A 57-year-old man with prior anteroseptal myocardial infarction underwent catheter ablation of ventricular tachycardia (VT) exhibiting a left bundle branch block QRS morphology. After failed left ventricular ablation, catheter ablation from the right ventricle (RV) eliminated the VT. An RV voltage map demonstrated an area of low voltage around the ...

Radiofrequency ablation at the posterior papillary muscle (PM) significantly reduced ventricular fibrillation (VF) inducibility in rabbits and dogs, suggesting that PM may be involved in the generation of VF. However, the effect of ablation at the PM on VF inducibility remains unknown in normal intact swine hearts because in this ...

The summit of the left ventricle (LV) is the most superior portion of the epicardial LV bounded by an arc from the left anterior descending coronary artery, superior to the first septal perforating branch to the left circumflex coronary artery. Ventricular arrhythmias (VAs) originating from this region may present challenges ...

We report a case of an atrial tachycardia (AT) originating from the left atrium (LA) associated with cor triatriatum sinister. Electroanatomical mapping of the 2 subdivided chambers of the LA during the AT revealed a centrifugal activation pattern from the posterior wall of the accessory chamber near the left superior ...

We report a case of atrioventricular nodal reentrant tachycardia (AVNRT) coexistent with His bundle anomaly and atrial septal defects. The His-bundle potential was recorded at the coronary sinus (CS) ostium. Fractionated atrial potentials and an A:V electrogram ratio 1:3 were recorded at the anterior septum of the tricuspid annulus approximately ...